Original articleIris Morphologic Changes Related to α1-Adrenergic Receptor Antagonists: Implications for Intraoperative Floppy Iris Syndrome
Section snippets
Patients and Methods
This noninterventional, cross-sectional study adhered to the tenets of the Declaration of Helsinki, was compliant with the Health Insurance Portability and Accountability Act, and was approved by the Institutional Review Board of The New York Eye and Ear Infirmary. Written informed consent was obtained from all subjects.
Results
Characteristics of patients in both groups are given in Table 1. Most patients in the study group were currently under treatment (22/29) and on tamsulosin (27/29). The other 2 patients were on terazosin. Patients in the study group had been treated with a systemic α-1ARA for 28.2±24.6 months. Regarding glaucoma diagnosis, there were no significant differences between study and control groups for open-angle glaucoma (34% vs. 31%), angle-closure glaucoma (38% vs. 42%), and glaucoma suspects (28%
Discussion
There is a significant difference in iris morphology in patients with a past or current history of α-1ARA use as compared with age-matched controls. Treated patients had significantly decreased DMR thicknesses, lower DMR/SMR ratios, and smaller pupillary diameters. These alterations seem to be related to the length of time of α-1ARA usage.
This is the first report demonstrating a structural alteration in the iris DMR in patients using α-1ARAs. These alterations presumably account for the
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Manuscript no: 2008-1229.
Financial Disclosure(s): R. Ritch: Alcon (c), Allergan (c), Merck (c), Pfizer (c), Ocular Instruments (p).
J.M. Liebmann: Heidelberg (instrument support).
None of the other authors have any conflict of interest regarding the present study.
Supported in part by the Educational Foundation of America, Westport, Connecticut. Supported in part by the NIH (grant no. NIH-R01-EY1579502).